First report of generalized face processing difficulties in möbius sequence

Overview of Unilateral and Bilateral Pediatric Facial Paralysis: Workup, Treatment, and Frontiers

Pediatric facial nerve paralysis can present significant challenges based on its various etiologies, unique approach to treatment options, and overall outcomes. It can impact both the child and parent when regarding function, appearance, and psychosocial implications. The etiology of facial nerve palsy can include congenital, traumatic, iatrogenic, and idiopathic causes. In some, the paralysis is transient while others have permanent loss of function. A thorough evaluation and differential diagnosis are essential to guide treatment planning. The purpose of this paper is to review facial paralysis in children with a focus on surgical management.

Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report

BACKGROUND/OBJECTIVES

Prosopagnosia is the inability to recognize people by their faces. Developmental prosopagnosia is the hereditary or congenital variant of the condition. The aim of this study was to demonstrate the assessment of developmental prosopagnosia in a clinical context, using a combination of commercially available clinical assessment tools and experimental tools described in the research literature.

METHODS

We conducted a comprehensive neuropsychological assessment of a man with Tourette syndrome and attention deficit hyperactivity disorder (ADHD). The patient (ON) had experienced difficulties with face identity recognition throughout his life but believed they were caused by a lack of interest in others.

RESULTS

The neuropsychological assessment revealed varying degrees of difficulties primarily related to executive functions, attention, reaction time, and memory processes, as expected in a person with Tourette's syndrome and ADHD. In addition, ON reported severe problems with face recognition on a prosopagnosia questionnaire and demonstrated severely impaired performance on tests of face memory and face perception commonly used to diagnose prosopagnosia. Interestingly, he reported familial face recognition problems on the maternal side of the family, while tics and ADHD symptoms occurred on the paternal side. This suggests that, in this case, the conditions were likely inherited through different genetic pathways.

CONCLUSIONS

Proper assessment of face recognition problems, which includes a broad spectrum of clinical assessment tools, could help patients develop awareness and acceptance of themselves and their difficulties, and could serve as a basis for the development of clinical interventions. While ON's DP, Tourette syndrome, and ADHD may have distinct genetic origins, impairment in face identity recognition has been observed across several neurodevelopmental conditions and is likely more common than currently thought.

On the Role of Sensorimotor Experience in Facial Expression Perception

Humans recognize the facial expressions of others rapidly and effortlessly. Although much is known about how we perceive expressions, the role of facial experience in shaping this remarkable ability remains unclear. Is our perception of expressions linked to how we ourselves make facial expressions? Are we better at recognizing other's facial expressions if we are experts at making the same expressions ourselves? And if we could not make facial expressions at all, would it impact our ability to recognize others' facial expressions? The current article aims to examine these questions by explicating the link between facial experience and facial expression recognition. It includes a comprehensive appraisal of the related literature and examines three main theories that posit a connection between making and recognizing facial expressions. First, recent studies in individuals with Moebius syndrome support the role of facial ability (i.e., the ability to move one's face to make facial expressions) in facial expression recognition. Second, motor simulation theory suggests that humans recognize others' facial expressions by covertly mimicking the observed expression (without overt motor action) and that this facial mimicry helps us identify and feel the associated emotion. Finally, the facial feedback hypothesis provides a framework for enhanced emotional experience via proprioceptive feedback from facial muscles when mimicking a viewed facial expression. Evidence for and against these theories is presented as well as some considerations and outstanding questions for future research studies investigating the role of facial experience in facial expression perception.

Emotional contagion to vocal smile revealed by combined pupil reactivity and motor resonance

The interplay between the different components of emotional contagion (i.e. emotional state and facial motor resonance), both during implicit and explicit appraisal of emotion, remains controversial. The aims of this study were (i) to distinguish between these components thanks to vocal smile processing and (ii) to assess how they reflect implicit processes and/or an explicit appraisal loop. Emotional contagion to subtle vocal emotions was studied in 25 adults through motor resonance and Autonomic Nervous System (ANS) reactivity. Facial expressions (fEMG: facial electromyography) and pupil dilation were assessed during the processing and judgement of artificially emotionally modified sentences. fEMG revealed that Zygomaticus major was reactive to the perceived valence of sounds, whereas the activity of Corrugator supercilii reflected explicit judgement. Timing analysis of pupil dilation provided further insight into both the emotional state and the implicit and explicit processing of vocal emotion, showing earlier activity for emotional stimuli than for neutral stimuli, followed by valence-dependent variations and a late judgement-dependent increase in pupil diameter. This innovative combination of different electrophysiological measures shed new light on the debate between central and peripherical views within the framework of emotional contagion.

Inability to move one's face dampens facial expression perception

Humans rely heavily on facial expressions for social communication to convey their thoughts and emotions and to understand them in others. One prominent but controversial view is that humans learn to recognize the significance of facial expressions by mimicking the expressions of others. This view predicts that an inability to make facial expressions (e.g., facial paralysis) would result in reduced perceptual sensitivity to others' facial expressions. To test this hypothesis, we developed a diverse battery of sensitive emotion recognition tasks to characterize expression perception in individuals with Moebius Syndrome (MBS), a congenital neurological disorder that causes facial palsy. Using computer-based detection tasks we systematically assessed expression perception thresholds for static and dynamic face and body expressions. We found that while MBS individuals were able to perform challenging perceptual control tasks and body expression tasks, they were less efficient at extracting emotion from facial expressions, compared to matched controls. Exploratory analyses of fMRI data from a small group of MBS participants suggested potentially reduced engagement of the amygdala in MBS participants during expression processing relative to matched controls. Collectively, these results suggest a role for facial mimicry and consequent facial feedback and motor experience in the perception of others' facial expressions.

Boosting brain-computer interfaces with functional electrical stimulation: potential applications in people with locked-in syndrome

Individuals with a locked-in state live with severe whole-body paralysis that limits their ability to communicate with family and loved ones. Recent advances in brain-computer interface (BCI) technology have presented a potential alternative for these people to communicate by detecting neural activity associated with attempted hand or speech movements and translating the decoded intended movements to a control signal for a computer. A technique that could potentially enrich the communication capacity of BCIs is functional electrical stimulation (FES) of paralyzed limbs and face to restore body and facial movements of paralyzed individuals, allowing to add body language and facial expression to communication BCI utterances. Here, we review the current state of the art of existing BCI and FES work in people with paralysis of body and face and propose that a combined BCI-FES approach, which has already proved successful in several applications in stroke and spinal cord injury, can provide a novel promising mode of communication for locked-in individuals.

Perceptions of Patients with Facial Paralysis: Predicting Social Implications and Setting Goals

The goal of this article is to better understand the social impact of facial paralysis. Patients with facial paralysis may suffer from impaired social interactions, disruption of self-concept, psychological distress, and decreased overall quality of life. Vigilance in detecting patients suffering from mental health issues may result in providing early referral for psychological evaluation and psychosocial support resources complementing facial reanimation treatment.

Cosmetic appreciation and emotional processing in patients with a peripheral facial palsy: A systematic review

Background; The goal of this review is 1) to summarize the studies assessing PFP by casual observers, patients themselves and the cosmetic appreciation of the PFP and 2) to summarize the studies assessing whether there is a difference in emotional recognition/processing of facial emotions and/or cognitive tasks in patients with a PFP. Materials and Methods; A multi-database systematic literature search was performed using the following databases: Pubmed, Embase, Medline, and The Cochrane Library from the earliest date of each database up to December 2019. Population of interest consisted of patients with a PFP and studies that investigated cosmetic appreciation and/or emotional recognition and/or emotional processing in these patients. Two authors rated the methodological quality of the included studies independently using the 'Newcastle - Ottawa Quality Assessment Scale' for nonrandomised studies' (NOS). Two authors extracted the outcome data regarding cosmetic appreciation and/or emotional recognition/processing from the included studies. Results; Twelve hundred and thirty-two studies were found of which eleven studies met the inclusion criteria. Most studies were assessed to be of 'fair' to 'good' methodological quality. The Cohen's kappa (between author RL and SP) was 0.68. Two studies investigated emotional processing and/or emotional recognition. Nine studies investigated cosmetic appreciation in both patients and casual observers. Important findings of this systematic review are that there is a correlation between the perceived severity of the PFP of the patients and the ratings by casual observers. Secondly there seems to be a laterality difference in cosmetic appreciation and thirdly there might to be a decreased emotional recognition and processing in patients with a PFP. Conclusion; Emotional recognition and cosmetic appreciation in patients with a PFP is an under investigated area, in which further studies are needed to substantiate the findings in current literature.

Typically Efficient Lipreading without Motor Simulation

All it takes is a face-to-face conversation in a noisy environment to realize that viewing a speaker's lip movements contributes to speech comprehension. What are the processes underlying the perception and interpretation of visual speech? Brain areas that control speech production are also recruited during lipreading. This finding raises the possibility that lipreading may be supported, at least to some extent, by a covert unconscious imitation of the observed speech movements in the observer's own speech motor system-a motor simulation. However, whether, and if so to what extent, motor simulation contributes to visual speech interpretation remains unclear. In two experiments, we found that several participants with congenital facial paralysis were as good at lipreading as the control population and performed these tasks in a way that is qualitatively similar to the controls despite severely reduced or even completely absent lip motor representations. Although it remains an open question whether this conclusion generalizes to other experimental conditions and to typically developed participants, these findings considerably narrow the space of hypothesis for a role of motor simulation in lipreading. Beyond its theoretical significance in the field of speech perception, this finding also calls for a re-examination of the more general hypothesis that motor simulation underlies action perception and interpretation developed in the frameworks of motor simulation and mirror neuron hypotheses.

Efficient recognition of facial expressions does not require motor simulation

What mechanisms underlie facial expression recognition? A popular hypothesis holds that efficient facial expression recognition cannot be achieved by visual analysis alone but additionally requires a mechanism of motor simulation — an unconscious, covert imitation of the observed facial postures and movements. Here, we first discuss why this hypothesis does not necessarily follow from extant empirical evidence. Next, we report experimental evidence against the central premise of this view: we demonstrate that individuals can achieve normotypical efficient facial expression recognition despite a congenital absence of relevant facial motor representations and, therefore, unaided by motor simulation. This underscores the need to reconsider the role of motor simulation in facial expression recognition.

Children with facial paralysis due to Moebius syndrome exhibit reduced autonomic modulation during emotion processing

BACKGROUND

Facial mimicry is crucial in the recognition of others' emotional state. Thus, the observation of others' facial expressions activates the same neural representation of that affective state in the observer, along with related autonomic and somatic responses. What happens, therefore, when someone cannot mimic others' facial expressions?

METHODS

We investigated whether psychophysiological emotional responses to others' facial expressions were impaired in 13 children (9 years) with Moebius syndrome (MBS), an extremely rare neurological disorder (1/250,000 live births) characterized by congenital facial paralysis. We inspected autonomic responses and vagal regulation through facial cutaneous thermal variations and by the computation of respiratory sinus arrhythmia (RSA). These parameters provide measures of emotional arousal and show the autonomic adaptation to others' social cues. Physiological responses in children with MBS were recorded during dynamic facial expression observation and were compared to those of a control group (16 non-affected children, 9 years).

RESULTS

There were significant group effects on thermal patterns and RSA, with lower values in children with MBS. We also observed a mild deficit in emotion recognition in these patients.

CONCLUSION

Results support "embodied" theory, whereby the congenital inability to produce facial expressions induces alterations in the processing of facial expression of emotions. Such alterations may constitute a risk for emotion dysregulation.

Autonomic Responses to Emotional Stimuli in Children Affected by Facial Palsy: The Case of Moebius Syndrome

According to embodied simulation theories, others' emotions are recognized by the unconscious mimicking of observed facial expressions, which requires the implicit activation of the motor programs that produce a specific expression. Motor responses performed during the expression of a given emotion are hypothesized to be directly linked to autonomic responses associated with that emotional behavior. We tested this hypothesis in 9 children (M_age = 5.66) affected by Moebius syndrome (MBS) and 15 control children (M_age = 6.6). MBS is a neurological congenital disorder characterized by underdevelopment of the VI and VII cranial nerves, which results in paralysis of the face. Moebius patients' inability to produce facial expressions impairs their capacity to communicate emotions through the face. We therefore assessed Moebius children's autonomic response to emotional stimuli (video cartoons) by means of functional infrared thermal (fIRT) imaging. Patients showed weaker temperature changes compared to controls, suggesting impaired autonomic activity. They also showed difficulties in recognizing facial emotions from static illustrations. These findings reveal that the impairment of facial movement attenuates the intensity of emotional experience, probably through the diminished activation of autonomic responses associated with emotional stimuli. The current study is the first to investigate emotional responses in MBS children, providing important insights into the role of facial expressions in emotional processing during early development.

Congenital facial palsy and emotion processing: The case of Moebius syndrome

According to the Darwinian perspective, facial expressions of emotions evolved to quickly communicate emotional states and would serve adaptive functions that promote social interactions. Embodied cognition theories suggest that we understand others' emotions by reproducing the perceived expression in our own facial musculature (facial mimicry) and the mere observation of a facial expression can evoke the corresponding emotion in the perceivers. Consequently, the inability to form facial expressions would affect the experience of emotional understanding. In this review, we aimed at providing account on the link between the lack of emotion production and the mechanisms of emotion processing. We address this issue by taking into account Moebius syndrome, a rare neurological disorder that primarily affects the muscles controlling facial expressions. Individuals with Moebius syndrome are born with facial paralysis and inability to form facial expressions. This makes them the ideal population to study whether facial mimicry is necessary for emotion understanding. Here, we discuss behavioral ambiguous/mixed results on emotion recognition deficits in Moebius syndrome suggesting the need to investigate further aspects of emotional processing such as the physiological responses associated with the emotional experience during developmental age.

Embodying functionally relevant action sounds in patients with spinal cord injury

Growing evidence indicates that perceptual-motor codes may be associated with and influenced by actual bodily states. Following a spinal cord injury (SCI), for example, individuals exhibit reduced visual sensitivity to biological motion. However, a dearth of direct evidence exists about whether profound alterations in sensorimotor traffic between the body and brain influence audio-motor representations. We tested 20 wheelchair-bound individuals with lower skeletal-level SCI who were unable to feel and move their lower limbs, but have retained upper limb function. In a two-choice, matching-to-sample auditory discrimination task, the participants were asked to determine which of two action sounds matched a sample action sound presented previously. We tested aural discrimination ability using sounds that arose from wheelchair, upper limb, lower limb, and animal actions. Our results indicate that an inability to move the lower limbs did not lead to impairment in the discrimination of lower limb-related action sounds in SCI patients. Importantly, patients with SCI discriminated wheelchair sounds more quickly than individuals with comparable auditory experience (i.e. physical therapists) and inexperienced, able-bodied subjects. Audio-motor associations appear to be modified and enhanced to incorporate external salient tools that now represent extensions of their body schemas.

Managing the child with a diagnosis of Moebius syndrome: more than meets the eye

Moebius syndrome (MBS) is a congenital, non-progressive facial and abducens nerve palsy in the presence of full vertical gaze and may be associated with limb abnormalities and craniofacial dysmorphisms. MBS is now defined as a disorder of rhombencephalic maldevelopment and recent gene discoveries have shown this to be a dominant disorder in a subset of patients. Accurate diagnosis and management by a multidisciplinary team with expertise in congenital facial palsy is paramount.

Fostering Social Cognition through an Imitation- and Synchronization-Based Dance/Movement Intervention in Adults with Autism Spectrum Disorder: A Controlled Proof-of-Concept Study

BACKGROUND

Since social cognition is impaired in individuals with autism spectrum disorder (ASD), this study aimed at establishing the efficacy of a newly developed imitation- and synchronization-based dance/movement intervention (SI-DMI) in fostering emotion inference and empathic feelings (emotional reaction to feelings of others) in adults with high-functioning ASD.

METHODS

Fifty-five adults with ASD (IQ ≥85) who were blinded to the aim of the study were assigned to receive either 10 weeks of a dance/movement intervention focusing on interpersonal movement imitation and synchronization (SI-DMI, n = 27) or a control movement intervention (CMI, n = 24) focusing on individual motor coordination (2 participants from each group declined before baseline testing). The primary outcome measure was the objective Multifaceted Empathy Test targeting emotion inference and empathic feelings. Secondary outcomes were scores on the self-rated Interpersonal Reactivity Index. The well-established automatic imitation task and synchronization finger-tapping task were used to quantify effects on imitation and synchronization functions, complemented by the more naturalistic Assessment of Spontaneous Interaction in Movement.

RESULTS

Intention-to-treat analyses revealed that from baseline to 3 months, patients treated with SI-DMI showed a significantly larger improvement in emotion inference (d = 0.58), but not empathic feelings, than those treated with CMI (d = -0.04). On the close generalization level, SI-DMI increased synchronization skills and imitation tendencies, as well as whole-body imitation/synchronization and movement reciprocity/dialogue, compared to CMI.

CONCLUSIONS

SI-DMI can be successful in promoting emotion inference in adults with ASD and warrants further investigation.

Fashioning the Face: Sensorimotor Simulation Contributes to Facial Expression Recognition

When we observe a facial expression of emotion, we often mimic it. This automatic mimicry reflects underlying sensorimotor simulation that supports accurate emotion recognition. Why this is so is becoming more obvious: emotions are patterns of expressive, behavioral, physiological, and subjective feeling responses. Activation of one component can therefore automatically activate other components. When people simulate a perceived facial expression, they partially activate the corresponding emotional state in themselves, which provides a basis for inferring the underlying emotion of the expresser. We integrate recent evidence in favor of a role for sensorimotor simulation in emotion recognition. We then connect this account to a domain-general understanding of how sensory information from multiple modalities is integrated to generate perceptual predictions in the brain.

Inducing a concurrent motor load reduces categorization precision for facial expressions

Motor theories of expression perception posit that observers simulate facial expressions within their own motor system, aiding perception and interpretation. Consistent with this view, reports have suggested that blocking facial mimicry induces expression labeling errors and alters patterns of ratings. Crucially, however, it is unclear whether changes in labeling and rating behavior reflect genuine perceptual phenomena (e.g., greater internal noise associated with expression perception or interpretation) or are products of response bias. In an effort to advance this literature, the present study introduces a new psychophysical paradigm for investigating motor contributions to expression perception that overcomes some of the limitations inherent in simple labeling and rating tasks. Observers were asked to judge whether smiles drawn from a morph continuum were sincere or insincere, in the presence or absence of a motor load induced by the concurrent production of vowel sounds. Having confirmed that smile sincerity judgments depend on cues from both eye and mouth regions (Experiment 1), we demonstrated that vowel production reduces the precision with which smiles are categorized (Experiment 2). In Experiment 3, we replicated this effect when observers were required to produce vowels, but not when they passively listened to the same vowel sounds. In Experiments 4 and 5, we found that gender categorizations, equated for difficulty, were unaffected by vowel production, irrespective of the presence of a smiling expression. These findings greatly advance our understanding of motor contributions to expression perception and represent a timely contribution in light of recent high-profile challenges to the existing evidence base.

Training in Compensatory Strategies Enhances Rapport in Interactions Involving People with Möbius Syndrome

In the exploratory study reported here, we tested the efficacy of an intervention designed to train teenagers with Möbius syndrome (MS) to increase the use of alternative communication strategies (e.g., gestures) to compensate for their lack of facial expressivity. Specifically, we expected the intervention to increase the level of rapport experienced in social interactions by our participants. In addition, we aimed to identify the mechanisms responsible for any such increase in rapport. In the study, five teenagers with MS interacted with three naïve participants without MS before the intervention, and with three different naïve participants without MS after the intervention. Rapport was assessed by self-report and by behavioral coders who rated videos of the interactions. Individual non-verbal behavior was assessed via behavioral coders, whereas verbal behavior was automatically extracted from the sound files. Alignment was assessed using cross recurrence quantification analysis and mixed-effects models. The results showed that observer-coded rapport was greater after the intervention, whereas self-reported rapport did not change significantly. Observer-coded gesture and expressivity increased in participants with and without MS, whereas overall linguistic alignment decreased. Fidgeting and repetitiveness of verbal behavior also decreased in both groups. In sum, the intervention may impact non-verbal and verbal behavior in participants with and without MS, increasing rapport as well as overall gesturing, while decreasing alignment.

Spatiotemporal neural network dynamics for the processing of dynamic facial expressions

The dynamic facial expressions of emotion automatically elicit multifaceted psychological activities; however, the temporal profiles and dynamic interaction patterns of brain activities remain unknown. We investigated these issues using magnetoencephalography. Participants passively observed dynamic facial expressions of fear and happiness, or dynamic mosaics. Source-reconstruction analyses utilizing functional magnetic-resonance imaging data revealed higher activation in broad regions of the bilateral occipital and temporal cortices in response to dynamic facial expressions than in response to dynamic mosaics at 150–200 ms and some later time points. The right inferior frontal gyrus exhibited higher activity for dynamic faces versus mosaics at 300–350 ms. Dynamic causal-modeling analyses revealed that dynamic faces activated the dual visual routes and visual–motor route. Superior influences of feedforward and feedback connections were identified before and after 200 ms, respectively. These results indicate that hierarchical, bidirectional neural network dynamics within a few hundred milliseconds implement the processing of dynamic facial expressions.

High-Frequency Transcranial Random Noise Stimulation Enhances Perception of Facial Identity

Recently, a number of studies have demonstrated the utility of transcranial current stimulation as a tool to facilitate a variety of cognitive and perceptual abilities. Few studies, though, have examined the utility of this approach for the processing of social information. Here, we conducted 2 experiments to explore whether a single session of high-frequency transcranial random noise stimulation (tRNS) targeted at lateral occipitotemporal cortices would enhance facial identity perception. In Experiment 1, participants received 20 min of active high-frequency tRNS or sham stimulation prior to completing the tasks examining facial identity perception or trustworthiness perception. Active high-frequency tRNS facilitated facial identity perception, but not trustworthiness perception. Experiment 2 assessed the spatial specificity of this effect by delivering 20 min of active high-frequency tRNS to lateral occipitotemporal cortices or sensorimotor cortices prior to participants completing the same facial identity perception task used in Experiment 1. High-frequency tRNS targeted at lateral occipitotemporal cortices enhanced performance relative to motor cortex stimulation. These findings show that high-frequency tRNS to lateral occipitotemporal cortices produces task-specific and site-specific enhancements in face perception.

Independent and collaborative contributions of the cerebral hemispheres to emotional processing

Presented is a model suggesting that the right hemisphere (RH) directly mediates the identification and comprehension of positive and negative emotional stimuli, whereas the left hemisphere (LH) contributes to higher level processing of emotional information that has been shared via the corpus callosum. RH subcortical connections provide initial processing of emotional stimuli, and their innervation to cortical structures provides a secondary pathway by which the hemispheres process emotional information more fully. It is suggested that the LH contribution to emotion processing is in emotional regulation, social well-being, and adaptation, and transforming the RH emotional experience into propositional and verbal codes. Lastly, it is proposed that the LH has little ability at the level of emotion identification, having a default positive bias and no ability to identify a stimulus as negative. Instead, the LH must rely on the transfer of emotional information from the RH to engage higher-order emotional processing. As such, either hemisphere can identify positive emotions, but they must collaborate for complete processing of negative emotions. Evidence presented draws from behavioral, neurological, and clinical research, including discussions of subcortical and cortical pathways, callosal agenesis, commissurotomy, emotion regulation, mood disorders, interpersonal interaction, language, and handedness. Directions for future research are offered.

Intranasal inhalation of oxytocin improves face processing in developmental prosopagnosia

Developmental prosopagnosia (DP) is characterised by a severe lifelong impairment in face recognition. In recent years it has become clear that DP affects a substantial number of people, yet little work has attempted to improve face processing in these individuals. Intriguingly, recent evidence suggests that intranasal inhalation of the hormone oxytocin can improve face processing in unimpaired participants, and we investigated whether similar findings might be noted in DP. Ten adults with DP and 10 matched controls were tested using a randomized placebo-controlled double-blind within-subject experimental design (AB-BA). Each participant took part in two testing sessions separated by a 14-25 day interval. In each session, participants inhaled 24 IU of oxytocin or placebo spray, followed by a 45 min resting period to allow central oxytocin levels to plateau. Participants then completed two face processing tests: one assessing memory for a set of newly encoded faces, and one measuring the ability to match simultaneously presented faces according to identity. Participants completed the Multidimensional Mood Questionnaire (MMQ) at three points in each testing session to assess the possible mood-altering effects of oxytocin and to control for attention and wakefulness. Statistical comparisons revealed an improvement for DP but not control participants on both tests in the oxytocin condition, and analysis of scores on the MMQ indicated that the effect cannot be attributed to changes in mood, attention or wakefulness. This investigation provides the first evidence that oxytocin can improve face processing in DP, and the potential neural underpinnings of the findings are discussed alongside their implications for the treatment of face processing disorders.